What is sinusitis?

Sinusitis is an inflammation, or swelling, of the tissue lining the sinuses. There are 2 types of sinusitis:

  • Acute bacterial sinusitis: a sudden onset of cold symptoms such as runny nose, stuffy nose, and facial pain that does not go away after 10 days, or symptoms that seem to begin improving but return worse than the initial symptoms. It responds well to antibiotics and decongestants.
  • Chronic sinusitis: a condition defined by nasal congestion, drainage, facial pain/pressure, and decreased sense of smell for at least 12 weeks.

What are the sinuses?

Each of us has four paired cavities (spaces) in our head that are connected to the nose by narrow channels. These cavities, known as sinuses, produce thin mucus that drains out of the channels of the nose. This drainage helps keep the nose clean and free of particles and bacteria.

Who gets sinusitis?

Every year, approximately 1 billion Americans have at least 1 episode of viral sinusitis. About 37 million will develop a bacterial sinusitis. People who have the following conditions have a higher risk of sinusitis:

  • Nasal mucus membrane swelling, as from a common cold or allergies.
  • Blockage of drainage ducts, leading to trapping of mucus.
  • Structure differences that narrow the drainage ducts.
  • Conditions that result in an increased risk of infection.
  • Polyps (growths).

In children, common factors in the environment that contribute to sinusitis include allergies, illness from other children at day care or school, and smoke in the environment.

In adults, the contributing factors are most frequently viral infections, allergies, and smoking.

What causes sinusitis?

Normally, sinuses are filled with air. But when sinuses become blocked and filled with fluid, bacteria can grow and cause an infection (bacterial sinusitis).

Conditions that cause sinus blockage include:

Allergies, such as hay fever, can also cause swelling and poor drainage of the sinuses.

One confusing factor to consider is that many people with “sinus headaches” are actually suffering from migraines. In fact, in large clinical studies, up to 90% of people who reported sinus headaches were diagnosed with migraines instead. Migraines can cause headaches in combination with facial pressure over the sinuses, a runny nose, and nasal congestion. If you have symptoms that involve the sinuses, it may be difficult to tell if you have sinusitis, a cold, nasal allergy, or even a migraine. This article will describe the symptoms, diagnosis, and treatment of sinusitis, and how to tell the difference between sinusitis, cold, migraines, and nasal allergy.

What are the signs and symptoms of acute sinusitis?

The primary symptoms of acute sinusitis include:

  • Facial pain/pressure/tenderness
  • Nasal stuffiness
  • Nasal discharge (thick yellow or green discharge from nose), especially if it is long-lasting
  • Loss of smell and taste
  • Cough/congestion

Additional symptoms may include:

  • Fever of 102° or higher
  • Ear pain
  • Headache
  • Bad breath
  • Fatigue
  • Ache in upper jaw and teeth

What are the symptoms of the common cold?

An upper respiratory infection (the common cold) is usually caused by a virus that infects the nose and throat. Most upper respiratory infections are not bacterial and do not respond to antibiotics. A cold may cause swelling in the sinuses, preventing the outflow of mucus.

Cold symptoms include nasal congestion, runny nose, post-nasal drip (drop-by-drop release of nasal fluid into the back of the throat), headache, achiness, and fatigue. Cough and fever may also go along with these symptoms.

Cold symptoms usually build, peak, and slowly disappear. No treatment is necessary for a cold, but some medications can ease symptoms. For example, decongestants may decrease drainage and open the nasal passages. Analgesics (pain relievers) may help with fever and headache. Cough medication may help, as well. Colds will typically last from a few days to about a week.

What are the symptoms of nasal allergy?

Symptoms of nasal allergy include:

  • Sneezing
  • Itchy nose
  • Clear, watery nasal discharge
  • Nasal blockage
  • Feeling fatigued